Claire, 38

Thirteen or fourteen. I had a hard adolescence in ways I don't need to go into in detail - family instability, moving schools. The picking started on my face and moved to my back in my mid-teens, once I started getting spots there too. By the time I left for university I was picking both locations daily.

What I remember most about that time isn't the picking itself but the extraordinary amount of mental energy I spent on it. Calculating whether I could wear a backless dress. Buying clothes specifically to cover my back. Planning routes through my house that would avoid particular mirrors at particular times of day. I'd built a whole infrastructure of avoidance and concealment and I thought of that as managing it. Now I'd call it adapting to it, which is quite different.

For my back I reach for it when I'm undressing or in bed, before sleep. There's a searching quality - my hands go to the places I know are active and check them. It's checking that turns into picking. The back episodes are more automatic and less conscious than the face ones. I'll realise after several minutes that I've been doing it without deciding to.

Face picking is more deliberate, more mirror-dependent. I'll be getting ready and I'll be inspecting and the inspection creates new targets. I find something, I try to clear it, I make it worse. There's almost a compulsive quality to seeing it through - I've started, so I need to finish, even though finishing is always worse than I'd anticipated.

After twenty-five years of this, the aftermath is a bit quieter than it used to be. Not because I've recovered - because I've got so used to it. That normalisation is something I had to unlearn when I started actually trying to address it. I'd got so comfortable with the pattern that I couldn't see it clearly anymore.

That I can be fine and still do this. People associate things like this with crisis or acute distress, and they expect that when you're doing better in your life generally, it should get better too. But the picking has its own rhythm that isn't neatly correlated with how things are going. I've had stretches of life that were genuinely good - good relationship, stable work, genuinely happy - and the picking continued throughout. It's not simply a signal of unhappiness. It's become its own thing.

Also the relapse piece. People who know about it expect a recovery that goes in one direction. When I have a bad week they're confused because things seemed to be going well. The non-linearity of this is genuinely hard for people to hold. I've sometimes not told people about setbacks because managing their disappointment on top of managing my own is too much.

Yes, over a long period, and much more than I realised until I started actually looking at it. I have a teenager now and we were looking at old photos recently, holiday photos from when she was small. I'm in almost none of them. I was always the one behind the camera. I thought I just preferred that. When I actually sat with it, it was because I didn't want photos of my back or photos where my face was visible without me controlling the angle and the coverage.

I've avoided the kind of spontaneous swimming situation that happens on holidays, beach trips, spa days with friends. Situations where getting changed in front of people is required. I've got very good at saying no to things without it being conspicuous. The avoidance has become so fluent that I barely notice it.

Telling my partner was partly about the relationship and partly about addressing all the accommodation I'd built into my life. He needed to know why I was always dressed before he came upstairs. Why I always showered alone. What I was actually doing in the bathroom at night when he thought I was just slow at getting ready.

When I found a therapist who actually knew about skin picking specifically. I'd been in therapy for years before that - good therapy, helpful therapy - but my picking was treated as a symptom of the anxiety or depression we were working on, not as a thing in its own right that needed its own approach. When I finally got to someone who understood how dermatillomania works and what actually helps with it, things moved differently.

And telling my partner. That was the other shift. I'd been hiding it from him for four years into the relationship. When I finally told him, the conversation I'd feared for years turned out to be about forty minutes long and he was kind and curious and completely undramatic about it. The weight of the secret was so much larger than the reality of the conversation. That happens a lot with this condition, I think. The anticipation is almost always worse than the disclosure.

Genuinely ongoing, which is something I've had to make peace with. I don't think I'm going to have a moment where this is behind me. I think this is something I manage rather than something I cure. That's okay. I've spent a lot of energy looking for the thing that would fix it, and I've had to let go of that framing.

What's working: having my partner involved in a structured way. Not as a monitor or a enforcer - that doesn't work and it creates a weird dynamic - but as someone who notices if I'm in the bathroom for a long time, who creates opportunities for distraction in high-risk windows, who knows what he's working with and can be a useful presence. The relationship has changed since I told him. It feels more honest.

I worry about my daughter. There's a genetic component to BFRBs and she's thirteen now, which is the age I started. I'm watching for it in a way that I'm not entirely sure is helpful. I've decided that if I see anything, I'll give her the information I didn't have at thirteen - the name, the community, the understanding that it's not character deficiency. That seems like the most useful thing I can do.

Get support that's actually specific to this condition. Not all therapists know about skin picking and not all therapy helps with it equally. Someone who has worked with dermatillomania before will be more useful than a very good therapist who hasn't. There are specific approaches that work, and a therapist who has never encountered this will be guessing at what to try. It's worth looking for that specificity even if it takes a while to find.

And take seriously the distinction between adapting and recovering. I spent fifteen years thinking I was managing this because I'd built a functioning life around it. I had. But the life had huge sections missing from it - photos I wasn't in, experiences I'd avoided, truth I'd kept from people I loved. Functioning is not the same as living fully. Be honest with yourself about what the condition is actually costing you.

Tell someone who matters to you. The secrecy of this is its own burden and it doesn't protect you the way you think it does. It mostly just keeps you alone with something you shouldn't have to be alone with.